My husband Simon has got used to me forgetting our wedding anniversary, so it was fabulous when, last year, my mother offered to have the children for a few days so we could celebrate. We booked into my favourite spa hotel in Hampshire.
It was just what we needed – for me, a break from live 24-hour news presenting and, for Simon, from the intensity of running his architecture practice. A few weeks later, I found out I was pregnant.
I was 44 and already had three beautiful children – Sophie was 11, Joseph nine, and flame-haired Tom just six. News of a fourth came as a complete shock.
In fact, after the positive pregnancy test, I could hardly speak and had to ask Sophie to break the news to her dad. She called him at work. ‘Daddy, are you sitting down? Mummy’s pregnant again.’
The first scan at 12 weeks went smoothly and we were overjoyed. Relatives congratulated us and my girlfriends spluttered the foam off their cappuccinos in disbelief.
The weeks went by and we became more used to the idea of a new baby. But the atmosphere at our 20-week scan was different. There was a problem, the sonographer said.
Our baby had club foot, or talipes, where the feet grow in the wrong direction. One foot was definitely affected – the other was folded and tucked underneath his bottom so we didn’t know about that one for sure. I sobbed all the way home.
We blamed ourselves for having a baby in our 40s, although we know now that age is not a determining factor. Talipes is just one of the many conditions babies can be born with, like blindness or deafness. In fact, club foot is the most common birth defect – affecting one in 10,000 newborn babies. Intellectually, you take that in but deep inside you feel you must be to blame.
My colleagues at Sky News were ultra-supportive. In fact, one of the executive producers had already had a baby with club foot and we met him and his wife with their son one sunny morning in Hyde Park. We watched their boy skip from slide to swing and felt very relieved seeing his ease of movement.
Another friend had two children born with the condition and when we saw their little feet carry them happily down the street we began to relax. We learned that Byron, Dudley Moore and Steven Gerrard had been born with club foot. We started to feel less anxious.
Then, by chance, I saw a television documentary that featured the work of an amazing orthopaedic surgeon, Dr Steve Mannion, who works in Malawi, in one of the poorest parts of Africa, treating babies born with club foot.
There, the social consequences of leaving it untreated can be horrific as, without the ability to earn, some children are abandoned by their parents.
Known as the ‘Crocodile Dundee’ of orthopaedic surgery, Dr Mannion had learned of a little-known treatment pioneered in the US more than 30 years ago known as the Ponseti Method.
In the traditional surgical treatment of club foot, tight tendons and ligaments in the foot are cut and ‘released’ on the operating table and bones are pinned into place.
But Dr Ignacio Ponseti argued that this painful surgery yielded poor results and could lead to arthritis in later life. So he developed a radical new treatment, where babies’ feet are straightened by manipulation, a series of plaster casts and, later, special boots and bars to keep bones growing in the right direction.
In fact, the Ponseti Method, forced on Dr Mannion by the shortage of money and doctors in Malawi, had produced amazing results. It gave us great hope to learn that it was now being adopted as a new standard treatment for talipes babies in the UK. (Sadly, Dr Ponseti himself died recently.)
Steps, the UK talipes charity, estimates 80 per cent of children like James are now treated with this method.
The months rolled by, and at work the camera crew had to be ever more inventive with angles so that viewers would not miss the headlines while marvelling at my gigantic bump. James Edward Paul Middlehurst was born two days before Christmas last year. He is a beautiful, smiling little boy, with the most amazing dark eyes.
We were just about prepared for a year of club-foot treatment when we were dealt another devastating blow. As well as the club foot in his right leg, James’s left leg, which had been tucked up underneath his bottom, hadn’t grown properly, and never would.
He had a short thighbone (a condition called proximal femoral focal deficiency, or PFFD), no kneecap and was missing one of the two bones of the lower leg (known as fibular hemimelia). The remaining bone was bowed and too short and his foot was sticking out at right angles to his lower leg. This was a one-in-100,000 deformity and it was a totally useless limb. As a result, as James grows, this leg will not grow with him.
I fell into the arms of a nurse as I left the consulting room. I was desolate and felt myself crumple in front of her.
‘This is life,’ she said, with kindness and understanding. Those three words have stayed with me. In one instant she seemed to say: ‘It is not your fault, face up to this and accept it. And you are not the only one.’
I have seen her since and thanked her for that moment of support. She was right there when I needed her and yet she was just doing her job.
As the hours at the hospital passed, we realised our little man might not even be able to walk. It was even more critical that his ‘good’ leg – the right one with the club foot – was treated expertly. This would be his primary leg – the left one would have to be reconstructed, including the removal of his foot, in order for him to wear a prosthesis.
We were distraught. I remember seeing my husband with his forehead against the hospital consulting room wall trying to take it all in. Nothing prepares you for hearing doctors talk about amputating your six-day-old baby’s foot.
We had to take James for an X-ray. Our tears fell down on his bright red tummy as we held him on the X-ray table. An entry in my diary for that day simply reads: ‘The worst day of my life.’
It was Christmas and the kitchen was filled with presents and congratulations cards. A beautiful bouquet of flowers arrived from everyone at Sky News and calls were coming from work as colleagues read their internal mailshots announcing the arrival.
My parents were full of love for James. Mum told me: ‘I knew this one would be special.’ Dad held him closer than he had held any of the others when they were babies.
My close friend Jacquie Beltrao, sports presenter at Sky News, brought round a huge home-made chocolate cake and chilled champagne, which we shared as we talked.
Another close friend, a neighbour who has watched all my children grow, held me in her arms one evening when I wasn’t so strong and told me what an amazing child James would be in a family such as ours.
We all headed north for New Year. In fact, I think we’d have fallen apart if it hadn’t been for my husband’s two brothers and their wives. They talked to us, fed us (we would not have eaten otherwise) and listened to us. They gradually put us back together again.
The worst of it was (and it feels so odd to remember this now) we weren’t thrilled to bits with James. It was as if the joy of a newborn baby had been snatched from us. But they showed us how to be delighted with our little son. As we left, I tried to thank Simon’s older brother. He just smiled at me saying: ‘That’s what families are for.’ I’ll never forget it.
Back in London, scans showed James’s hips were forming well. We began to dare to hope that he would be able to walk. At Chelsea and Westminster Hospital, orthopaedic surgeon Alison Hulme began treating James’s club foot.
She came across as a disarming mix of an incredibly skilled professional and a favourite auntie. She took us through James’s treatment plan over the coming years with medical straightforwardness, saying his club foot leg would be treated using the Ponseti Method and the other leg would be ‘managed prosthetically’.
She did not shy away from telling us exactly what to expect, while also sweeping James up in her arms and cooing adoringly at him.
Denise Watson, James’s physiotherapist and Ponseti practitioner, was just as dotty about him.
‘He’s so gorgeous. Come to Auntie Denise,’ she would say, before whisking him off for a new plaster cast. She and her expert team began ‘training’ his club foot-affected leg to grow in the right direction. His first cast was fitted when he was less than a month old and was changed once a week until he was six months old.
Bath times were a challenge as we weren’t meant to get the plaster casts wet and James loves kicking and splashing in the water. But we found a way of waterproofing the casts and got on with it.
Crawling has also been surprisingly good. Denise predicted that with one short leg he might only crawl in circles (I think she was joking) but I’m proud to report James crawls, at speed, wherever he wants to.
He’s now 11 months old and his club-foot leg is a Ponseti success story. The plaster casts are history and he just wears a splint during the day to keep the bones growing in the right direction.
One night recently at bath time, he took all his weight on his newly treated leg, looked up at me and smiled triumphantly. As he beamed from ear to ear, I knew this determined little baby was also determined to walk.
Our next hurdle is the reconstruction of his left leg and the amputation of his left foot. That’s scheduled for this Tuesday and we know it will be tough.
As we prepare for it, his leg is being slowly stretched with physio to make a straighter limb. The operation will create a ‘stump’ (or ‘lever’ as they like to call it) at his ankle and his prosthetic leg will be fitted next month.
Just like his casts, those will be changed as he grows. We know that as soon as he gets his new false leg, his Ponseti-treated leg will be the most important part of taking those magical first few steps. The doctors are not sure how often the prosthetic will need to be changed, but perhaps every six months or so.
It’s been quite a journey and I’ve been back at work since June. Colleagues at Sky News have been wonderful. And we have learned masses from our children.
Joseph stood up in class and told his friends that his little brother would soon have a ‘cool bionic leg’ and announced that if there was a fancy-dress party, James would definitely win as a pirate, the only contestant genuinely wearing a false leg.
Tom thinks that if James’s leg means he can’t be a striker at football, he can be a goalie. And Sophie said to me: ‘Mummy, James’s disability makes me love him more because I think he needs us more.’
Little James Middlehurst may have had an uncertain start to his life but with expert NHS treatment – not to mention the devotion of his siblings and love from us – we know he’ll go a long way. We now know he will walk and run and live a full life.
We also know he won’t be playing for Manchester United. But there’s nothing stopping him from being an architect like his daddy or a newsreader like his mummy.
Interview by Vincent Graff
• Dr Steve Mannion’s charity, at www.feetfirstworldwide.com